Monday, 21 September 2015

How well do nurse prescribers perform?

Roger Watson, Editor-in-Chief

Nurses now commonly perform roles that were once the preserve of medical practitioners and prescribing medication is one example. Nurse prescribers are now very common and, according to a recent article by Courtenay et al. (2015) titled: 'A comparison of prescribing and non-prescribing nurses in the management of people with diabetes' and published in JAN, there are 28,000 nurses in the UK who can prescribe the same medications as their medical colleagues. But are they any better at this than nurses who do not prescribe and who after people with diabetes but who depend on their medical colleagues to prescribe?

The aim of this study, in the authors own words, were: 'to compare nurse prescribers and non-prescribers managing people with diabetes in general practice regarding: (a) patient characteristics; (b) activities and processes of care; (c) patient outcomes (self-management, clinical indicators, satisfaction) and (d) resource implications and costs.' Six nurses managing people with diabetes who could prescribe were compared with six who did not and they were followed up over 6 months.

The main finding was that both cared equally well but that patients were more satisfied with nurse prescribers and they were more expensive to employ than non-prescribing nurses. This is good news for nurse prescribers and for patients but, as the authors warn in their conclusion: 'From nurses’ perspectives, holding an independent prescribing qualification may enhance career prospects and add to job satisfaction, but budget conscious GP practices may question the rationale of investing in a more expensive resource when a nurse commanding a lower salary can produce similar outcomes.'